Provider Demographics
NPI:1851390926
Name:COTHRAN-ROSS, TANYA Y (MD)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:Y
Last Name:COTHRAN-ROSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TANYA
Other - Middle Name:Y
Other - Last Name:COTHRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:501 N FREDERICK AVE
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2507
Mailing Address - Country:US
Mailing Address - Phone:301-258-7158
Mailing Address - Fax:301-258-7252
Practice Address - Street 1:501 N FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2507
Practice Address - Country:US
Practice Address - Phone:301-258-7158
Practice Address - Fax:301-258-7252
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD034923208000000X
SC21020208000000X
MDD0064619208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics